Taif University

Gum arabic (GA), a water-soluble dietary fiber rich in Ca(2+), Mg(2+) and K(+), is used in Middle Eastern countries for the treatment of patients with chronic kidney disease. Recent animal experiments shed some light into mechanisms involved in the therapeutic action of GA. According to experiments in healthy mice, GA treatment increases creatinine clearance, enhances renal excretion of ADH, Mg(2+) and Ca(2+), decreases plasma phosphate concentration as well as urinary excretion of phosphate and Na(+). In diabetic mice GA treatment increases urinary Ca(2+) excretion, and decreases plasma phosphate concentration, plasma urea concentration, urinary flow rate, natriuresis, phosphaturia, glucosuria, proteinuria as well as blood pressure. Extrarenal effects of GA treatment in mice include decreased expression of intestinal Na(+) coupled glucose carrier SGLT1 with subsequent delay of electrogenic intestinal glucose transport, glucose-induced hyperglycemia, hyperinsulinemia and body weight gain. GA treatment decreases colonic transcription of the angiogenetic factors angiogenin 1, angiogenin 3 and angiogenin 4, of CD38 antigen, aquaporin4, interleukin18, vav-3-oncogene, y(+)-amino acid-transporter, sulfatase1, ubiquitinD and chemokine ligand5. Moreover, GA treatment decreases angiogenin and ß-catenin protein expression. Accordingly, GA treatment counteracts the development of tumors following chemical cancerogenesis. In mouse dendritic cells, antigen-presenting cells linking innate and adaptive immunity, GA treatment modifies maturation and cytokine release. GA treatment further favourably influences the course of murine malaria. The effects of GA treatment on plasma phosphate concentration, blood pressure and proteinuria may prove beneficial in chronic renal failure and diabetic nephropathy. The effect of GA on intestinal glucose transport may be useful in the prophylaxis and treatment of obesity and diabetes, the effect of GA on angiogenin and ß-catenin expression could be exploited for the prophylaxis against colon carcinoma, the effects of GA on angiogenin expression and dendritic cells may be useful in the treatment of inflammatory disease and malaria.

Heavy metals are well-known environmental pollutants owing to their toxicity, longevity in the atmosphere, and ability to accumulate in the human body via bioaccumulation. The pollution of terrestrial and aquatic ecosystems with toxic heavy metals is a major environmental concern that has consequences for public health. Most heavy metals occur naturally, but a few are derived from anthropogenic sources. Heavy metals are characterized by their high atomic mass and toxicity to living organisms. Most heavy metals cause environmental and atmospheric pollution, and may be lethal to humans. Heavy metals can become strongly toxic by mixing with different environmental elements, such as water, soil, and air, and humans and other living organisms can be exposed to them through the food chain. Plenty of experimental studies were performed to appraise the promising treatment options from natural products. Additionally, nanotechnology based treatment options are being constantly developed. As an emerging field, nanotechnology is making substantial advances in the analysis and removal of heavy metals from complicated matrices. Removal of heavy metal has been accomplished by the use of a variety of nanomaterials, including graphene and its derivatives, magnetic nanoparticles, metal oxide nanoparticles, and carbon nanotubes, to name a few. Using nanotechnology for heavy metal analysis and removal from food and water resources provides many benefits over traditional methods. These advantages include a broad linear range, low detection and quantification limits, a high sensitivity, and high selectivity. Therefore this review aimed to explore the environmental consequences of the heavy metals, toxicity to the human health, as well as novel therapeutics development from the natural resources. Additionally, nanotechnological and nanomedicinal applications to treat heavy metal toxicity are also highlighted in this review.

Several cancers are highly refractory to conventional chemotherapy. The survival of tumors in several cases is assisted by checkpoint immunomodulation to maintain the imbalance between immune surveillance and cancer cell proliferation. Check point antibody inhibitors, such as anti-PD-1/PD-L1, are a novel class of inhibitors that function as a tumor suppressing factor via modulation of immune cell-tumor cell interaction. These checkpoint blockers are rapidly becoming a highly promising cancer therapeutic approach that yields remarkable antitumor responses with limited side effects. In recent times, more than four check point antibody inhibitors have been commercialized for targeting PD-1, PDL-1, and CTLA-4. Despite the huge success and efficacy of the anti-PD therapy response, it is limited to specific types of cancers, which attributes to the insufficient and heterogeneous expression of PD-1 in the tumor microenvironment. Herein, we review the current landscape of the PD-1/PD-L1 mechanistic role in tumor immune evasion and therapeutic outcome for cancer treatment. We also review the current progress in clinical trials, combination of drug therapy with immunotherapy, safety, and future of check point inhibitors for multiple types of cancer.

The increasing wireless data traffic demands have driven the need to explore suitable spectrum regions for meeting the projected requirements. In the light of this, millimeter wave (mmWave) communication has received considerable attention from the research community. Typically, in fifth generation (5G) wireless networks, mmWave massive multiple-input multipleoutput (MIMO) communications is realized by the hybrid transceivers which combine high dimensional analog phase shifters and power amplifiers with lower-dimensional digital signal processing units. This hybrid beamforming design reduces the cost and power consumption which is aligned with an energy-efficient design vision of 5G. In this paper, we track the progress in hybrid beamforming for massive MIMO communications in the context of system models of the hybrid transceivers' structures, the digital and analog beamforming matrices with the possible antenna configuration scenarios and the hybrid beamforming in heterogeneous wireless networks. We extend the scope of the discussion by including resource management issues in hybrid beamforming. We explore the suitability of hybrid beamforming methods, both, existing and proposed till first quarter of 2017, and identify the exciting future challenges in this domain.

Osteoporosis is a growing health concern worldwide and its complications are as prevalent as other common chronic disease complications such as hypertension and diabetes. In this review, we will discuss the role of gender in osteoporosis, especially related to peak bone mass and maturation, rate of annual bone loss, screening, prevalence of osteoporosis and its related fractures, mortality after osteoporosis-related fracture, fracture risk predication using different technologies and the impact of gender on osteoporosis management.

This work was designed to evaluate whether external application of nitric oxide (NO) in the form of its donor S-nitroso-N-acetylpenicillamine (SNAP) could mitigate the deleterious effects of NaCl stress on chickpea (Cicer arietinum L.) plants. SNAP (50 μM) was applied to chickpea plants grown under non-saline and saline conditions (50 and 100 mM NaCl). Salt stress inhibited growth and biomass yield, leaf relative water content (LRWC) and chlorophyll content of chickpea plants. High salinity increased electrolyte leakage, carotenoid content and the levels of osmolytes (proline, glycine betaine, soluble proteins and soluble sugars), hydrogen peroxide (H2O2) and malondialdehyde (MDA), as well as the activities of antioxidant enzymes, such as superoxide dismutase (SOD), catalase (CAT), ascorbate peroxidase (APX), and glutathione reductase in chickpea plants. Expression of the representative SOD, CAT and APX genes examined was also up-regulated in chickpea plants by salt stress. On the other hand, exogenous application of NO to salinized plants enhanced the growth parameters, LRWC, photosynthetic pigment production and levels of osmolytes, as well as the activities of examined antioxidant enzymes which is correlated with up-regulation of the examined SOD, CAT and APX genes, in comparison with plants treated with NaCl only. Furthermore, electrolyte leakage, H2O2 and MDA contents showed decline in salt-stressed plants supplemented with NO as compared with those in NaCl-treated plants alone. Thus, the exogenous application of NO protected chickpea plants against salt stress-induced oxidative damage by enhancing the biosyntheses of antioxidant enzymes, thereby improving plant growth under saline stress. Taken together, our results demonstrate that NO has capability to mitigate the adverse effects of high salinity on chickpea plants by improving LRWC, photosynthetic pigment biosyntheses, osmolyte accumulation and antioxidative defense system.

Breast cancer is a global cause for concern owing to its high incidence around the world. The alarming increase in breast cancer cases emphasizes the management of disease at multiple levels. The management should start from the beginning that includes stringent cancer screening or cancer registry to effective diagnostic and treatment strategies. Breast cancer is highly heterogeneous at morphology as well as molecular levels and needs different therapeutic regimens based on the molecular subtype. Breast cancer patients with respective subtype have different clinical outcome prognoses. Breast cancer heterogeneity emphasizes the advanced molecular testing that will help on-time diagnosis and improved survival. Emerging fields such as liquid biopsy and artificial intelligence would help to under the complexity of breast cancer disease and decide the therapeutic regimen that helps in breast cancer management. In this review, we have discussed various risk factors and advanced technology available for breast cancer diagnosis to combat the worst breast cancer status and areas that need to be focused for the better management of breast cancer.

The COVID-19 pandemic has infected millions worldwide, leaving a global burden for long-term care of COVID-19 survivors. It is thus imperative to study post-COVID (i.e., short-term) and long-COVID (i.e., long-term) effects, specifically as local and systemic pathophysiological outcomes of other coronavirus-related diseases (such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS)) were well-cataloged. We conducted a comprehensive review of adverse post-COVID health outcomes and potential long-COVID effects. We observed that such adverse outcomes were not localized. Rather, they affected different human systems, including: (i) immune system (e.g., Guillain-Barré syndrome, rheumatoid arthritis, pediatric inflammatory multisystem syndromes such as Kawasaki disease), (ii) hematological system (vascular hemostasis, blood coagulation), (iii) pulmonary system (respiratory failure, pulmonary thromboembolism, pulmonary embolism, pneumonia, pulmonary vascular damage, pulmonary fibrosis), (iv) cardiovascular system (myocardial hypertrophy, coronary artery atherosclerosis, focal myocardial fibrosis, acute myocardial infarction, cardiac hypertrophy), (v) gastrointestinal, hepatic, and renal systems (diarrhea, nausea/vomiting, abdominal pain, anorexia, acid reflux, gastrointestinal hemorrhage, lack of appetite/constipation), (vi) skeletomuscular system (immune-mediated skin diseases, psoriasis, lupus), (vii) nervous system (loss of taste/smell/hearing, headaches, spasms, convulsions, confusion, visual impairment, nerve pain, dizziness, impaired consciousness, nausea/vomiting, hemiplegia, ataxia, stroke, cerebral hemorrhage), (viii) mental health (stress, depression and anxiety). We additionally hypothesized mechanisms of action by investigating possible molecular mechanisms associated with these disease outcomes/symptoms. Overall, the COVID-19 pathology is still characterized by cytokine storm that results to endothelial inflammation, microvascular thrombosis, and multiple organ failures.

The field of Medicine and Healthcare has attained revolutionary advancements in the last forty years. Within this period, the actual reasons behind numerous diseases were unveiled, novel diagnostic methods were designed, and new medicines were developed. Even after all these achievements, diseases like cancer continue to haunt us since we are still vulnerable to them. Cancer is the second leading cause of death globally; about one in every six people die suffering from it. Among many types of cancers, the lung and colon variants are the most common and deadliest ones. Together, they account for more than 25% of all cancer cases. However, identifying the disease at an early stage significantly improves the chances of survival. Cancer diagnosis can be automated by using the potential of Artificial Intelligence (AI), which allows us to assess more cases in less time and cost. With the help of modern Deep Learning (DL) and Digital Image Processing (DIP) techniques, this paper inscribes a classification framework to differentiate among five types of lung and colon tissues (two benign and three malignant) by analyzing their histopathological images. The acquired results show that the proposed framework can identify cancer tissues with a maximum of 96.33% accuracy. Implementation of this model will help medical professionals to develop an automatic and reliable system capable of identifying various types of lung and colon cancers.

Smart cities contain intelligent things which can intelligently automatically and collaboratively enhance life quality, save people's lives, and act a sustainable resource ecosystem. To achieve these advanced collaborative technologies such as drones, robotics, artificial intelligence, and Internet of Things (IoT) are required to increase the smartness of smart cities by improving the connectivity, energy efficiency, and quality of services (QoS). Therefore, collaborative drones and IoT play a vital role in supporting a lot of smart-city applications such as those involved in communication, transportation, agriculture,safety and security, disaster mitigation, environmental protection, service delivery, energy saving, e-waste reduction, weather monitoring, healthcare, etc. This paper presents a survey of the potential techniques and applications of collaborative drones and IoT which have recently been proposed in order to increase the smartness of smart cities. It provides a comprehensive overview highlighting the recent and ongoing research on collaborative drone and IoT in improving the real-time application of smart cities. This survey is different from previous ones in term of breadth, scope, and focus. In particular, we focus on the new concept of collaborative drones and IoT for improving smart-city applications. This survey attempts to show how collaborative drones and IoT improve the smartness of smart cities based on data collection, privacy and security, public safety, disaster management, energy consumption and quality of life in smart cities. It mainly focuses on the measurement of the smartness of smart cities, i.e., environmental aspects, life quality, public safety, and disaster management.

This paper aims to explore and investigate the potential factors influencing students' behavioral intentions to use the e-learning system. This paper proposes an extended technology acceptance model (TAM) that has been tested and examined through the use of both innovation diffusion theory (IDT) and integrating TAM. This paper was conducted on 1286 students utilizing systems of e-learning in Malaysia. The findings were obtained via a quantitative research method. The findings illustrate that six perceptions of innovation characteristics, in particular, have impacts on students' e-learning system behavioral intention. The influences of the relative advantages, observability, trialability, perceived compatibility, complexity, and perceived enjoyment on the perceived ease of use is noteworthy. Moreover, the effects of the relative advantages, complexity, trialability, observability, perceived compatibility, and perceived enjoyment on the perceived usefulness have a strong impact. Therefore, the empirical results provide strong backing to the integrative approach between TAM and IDT. The findings suggest an extended model of TAM with IDT for the acceptance of the e-learning system used to improve the students' learning performance, which can help decision makers in higher education, universities, as well as colleges to evaluate, plan and execute the use of e-learning systems.

In this study, zinc oxide nanoparticles (ZnO-NPs) were successfully fabricated through the harnessing of metabolites present in the cell filtrate of a newly isolated and identified microalga Arthrospira platensis (Class: Cyanophyceae). The formed ZnO-NPs were characterized by UV–Vis spectroscopy, Fourier transform infrared (FT-IR), transmission electron microscopy (TEM), energy-dispersive spectroscopy (EDX), X-ray diffraction (XRD), and X-ray photoelectron spectroscopy (XPS). Data showed the efficacy of cyanobacterial metabolites in fabricating spherical, crystallographic ZnO-NPs with a size ≈30.0 to 55.0 nm at a wavelength of 370 nm. Moreover, FT-IR analysis showed varied absorption peaks related to nanoparticle formation. XPS analysis confirms the presence of Zn(II)O at different varied bending energies. Data analyses exhibit that the activities of biosynthesized ZnO-NPs were dose-dependent. Their application as an antimicrobial agent was examined and formed clear zones, 24.1 ± 0.3, 21.1 ± 0.06, 19.1 ± 0.3, 19.9 ± 0.1, and 21.6 ± 0.6 mm, at 200 ppm against Bacillus subtilis, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Candida albicans, respectively, and these activities were reduced as the NPs concentration decreased. The minimum inhibitory concentration (MIC) values were determined as 50 ppm for S. aureus, 25 ppm for P. aeruginosa, and 12.5 ppm for B. subtilis, E. coli, and C. albicans. More interestingly, ZnO-NPs exhibit high in vitro cytotoxic efficacy against cancerous (Caco-2) (IC50 = 9.95 ppm) as compared with normal (WI38) cell line (IC50 = 53.34 ppm).

Abstract With the innovation of microelectronics technology, the heat dissipation problem inside the device will face a severe test. In this work, cellulose aerogel (CA) with highly enhanced thermal conductivity (TC) in vertical planes was successfully obtained by constructing a vertically aligned silicon carbide nanowires (SiC NWs)/boron nitride (BN) network via the ice template-assisted strategy. The unique network structure of SiC NWs connected to BN ensures that the TC of the composite in the vertical direction reaches 2.21 W m −1 K −1 at a low hybrid filler loading of 16.69 wt%, which was increased by 890% compared to pure epoxy (EP). In addition, relying on unique porous network structure of CA, EP-based composite also showed higher TC than other comparative samples in the horizontal direction. Meanwhile, the composite exhibits good electrically insulating with a volume electrical resistivity about 2.35 × 10 11 Ω cm and displays excellent electromagnetic wave absorption performance with a minimum reflection loss of − 21.5 dB and a wide effective absorption bandwidth (< − 10 dB) from 8.8 to 11.6 GHz. Therefore, this work provides a new strategy for manufacturing polymer-based composites with excellent multifunctional performances in microelectronic packaging applications.

Abstract Soil salinity is established as one of the major environmental problems, decreasing crop productivity worldwide, thereby threatening sustainable agriculture. In the present study, we evaluated the effects of titanium dioxide nanoparticles (nTiO 2 ) for ameliorating soil salinity in broad bean, an important leguminous crop. As nTiO 2 is known to have pro‐oxidant and antioxidant properties, the effects of three different nTiO 2 concentrations (0·01%, 0·02% and 0·03%) were compared with respect to plant growth and stress responses. The 0·01% nTiO 2 application significantly increased shoot length, leaf area and root dry weight of plants under normal conditions. These growth‐promoting effects were simultaneous with increased levels of chlorophyll b, soluble sugars and proline and enhanced activities of antioxidant enzymes. Under saline soil conditions, although proline level and enzymatic antioxidant activities were increased, plant growth significantly reduced. The 0·01% nTiO 2 supplementation significantly increased the activities of enzymatic antioxidants and levels of soluble sugars, amino acids and proline in salt‐affected plants versus plants subjected to salinity alone. Thus, the increased antioxidant enzyme activities contributed to the observed reduction in hydrogen peroxide and malondialdehyde contents, while enhanced levels of proline and other metabolites contributed to osmoprotection, collectively resulting in significant plant growth improvement under salinity. Furthermore, nTiO 2 ‐mediated positive effects were concentration dependent with 0·01% nTiO 2 being the most effective, whereas 0·02% showed an intermediate response and 0·03% was almost ineffective under both control and saline soil conditions. Our findings provide a foundation for nTiO 2 application in improving growth of plants cultivated on naturally contaminated saline soils. Copyright © 2017 John Wiley & Sons, Ltd.

Water shortage and salinity are major challenges for sustaining global food security. Using nutrients in the nano-scale formulation including zinc oxide nanoparticles (ZnO NP) is a novel fertilization strategy for crops. In this study, two field-based trials were conducted during 2018 and 2019 to examine the influence of three ZnO NP concentrations (0, 50, and 100 ppm) in eggplant grown under full irrigation (100 of crop evapotranspiration; ETc) and drought stress (60% of ETc). Plant growth, yield, water productivity (WP), physiology, biochemistry, and anatomy responses were evaluated. Drought stress significantly decreased membrane stability index (MSI), relative water content (RWC), and photosynthetic efficiency, thus hampered eggplant growth and yield. In contrast, exogenous ZnO NP to water-stressed eggplant resulted in increased RWC and MSI associated with improved stem and leaf anatomical structures and enhanced photosynthetic efficiency. Under drought stress, supplementation of 50 and 100 ppm ZnO NP improved growth characteristics and increased fruit yield by 12.2% and 22.6%, respectively, compared with fully irrigated plants and nonapplied ZnO NP. The highest water productivity (WP) was obtained when eggplant was irrigated with 60% ETc and foliarly treated with 50 or 100 ppm of ZnO NP, which led to 50.8-66.1% increases in WP when compared with nontreated fully irrigated plants. Collectively, these findings demonstrated that foliar spraying ZnO NP gives the utility for alleviating drought stress effects on eggplant cultivated in saline soil.

Industrial development with the growth, strengthening, stability, technical advancement, reliability, selection, and dynamic response of the power system is essential. Governments and companies invest billions of dollars in technologies to convert, harvest, rising demand, changing demand and supply patterns, efficiency, lack of analytics required for optimal energy planning, and store energy. In this scenario, artificial intelligence (AI) is starting to play a major role in the energy market. Recognizing the importance of AI, this study was conducted on seven different energetics systems and their variety of applications, including: i) electricity production; ii) power delivery; iii) electric distribution networks; iv) energy storage; v) energy saving, new energy materials, and devices; vi) energy efficiency and nanotechnology; and vii) energy policy, and economics. The main drivers are the four key techniques used in current AI technologies, including: i) fuzzy logic systems; ii) artificial neural networks; iii) genetic algorithms; and iv) expert systems. In developed countries, the power industry has started using AI to connect with smart meters, smart grids, and the Internet of Things devices. These AI technologies will lead to the improvement of efficiency, energy management, transparency, and the usage of renewable energies. In recent decades/years, new AI technology has brought significant improvements to how power system devices monitor data, communicate with the system, analyze input–output, and display data in unprecedented ways. New applications in the energy system become feasible when these new AI developments are incorporated into the energy industry. But on the contrary, much more investment is needed in global research into AI and data-driven models. In terms of power supply, AI can help utilities provide customers with renewable and affordable electricity from complex sources in a secure manner, while at the same time providing these customers with the opportunity to use their own energy more efficiently. Moreover, policy recommendations, research opportunities, and how industry 4.0 will improve sustainability have been briefly described.

Abstract The development of the Internet of Things (IoT) technology and their integration in smart cities have changed the way we work and live, and enriched our society. However, IoT technologies present several challenges such as increases in energy consumption, and produces toxic pollution as well as E-waste in smart cities. Smart city applications must be environmentally-friendly, hence require a move towards green IoT. Green IoT leads to an eco-friendly environment, which is more sustainable for smart cities. Therefore, it is essential to address the techniques and strategies for reducing pollution hazards, traffic waste, resource usage, energy consumption, providing public safety, life quality, and sustaining the environment and cost management. This survey focuses on providing a comprehensive review of the techniques and strategies for making cities smarter, sustainable, and eco-friendly. Furthermore, the survey focuses on IoT and its capabilities to merge into aspects of potential to address the needs of smart cities. Finally, we discuss challenges and opportunities for future research in smart city applications.

Cloud computing has become a widely exploited research area in academia and industry. Cloud computing benefits both cloud services providers (CSPs) and consumers. The security challenges associated with cloud computing have been widely studied in the literature. This systematic literature review (SLR) is aimed to review the existing research studies on cloud computing security, threats, and challenges. This SLR examined the research studies published between 2010 and 2020 within the popular digital libraries. We selected 80 papers after a meticulous screening of published works to answer the proposed research questions. The outcomes of this SLR reported seven major security threats to cloud computing services. The results showed that data tampering and leakage were among the highly discussed topics in the chosen literature. Other identified security risks were associated with the data intrusion and data storage in the cloud computing environment. This SLR’s results also indicated that consumers’ data outsourcing remains a challenge for both CSPs and cloud users. Our survey paper identified the blockchain as a partnering technology to alleviate security concerns. The SLR findings reveal some suggestions to be carried out in future works to bring data confidentiality, data integrity, and availability.

BACKGROUND: For more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions. METHODS: The GBD 2023 combined analysis estimated years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 375 diseases and injuries, and risk-attributable burden associated with 88 modifiable risk factors. Of the more than 310 000 total data sources used for all GBD 2023 (about 30% of which were new to this estimation round), more than 120 000 sources were used for estimation of disease and injury burden and 59 000 for risk factor estimation, and included vital registration systems, surveys, disease registries, and published scientific literature. Data were analysed using previously established modelling approaches, such as disease modelling meta-regression version 2.1 (DisMod-MR 2.1) and comparative risk assessment methods. Diseases and injuries were categorised into four levels on the basis of the established GBD cause hierarchy, as were risk factors using the GBD risk hierarchy. Estimates stratified by age, sex, location, and year from 1990 to 2023 were focused on disease-specific time trends over the 2010-23 period and presented as counts (to three significant figures) and age-standardised rates per 100 000 person-years (to one decimal place). For each measure, 95% uncertainty intervals [UIs] were calculated with the 2·5th and 97·5th percentile ordered values from a 250-draw distribution. FINDINGS: Total numbers of global DALYs grew 6·1% (95% UI 4·0-8·1), from 2·64 billion (2·46-2·86) in 2010 to 2·80 billion (2·57-3·08) in 2023, but age-standardised DALY rates, which account for population growth and ageing, decreased by 12·6% (11·0-14·1), revealing large long-term health improvements. Non-communicable diseases (NCDs) contributed 1·45 billion (1·31-1·61) global DALYs in 2010, increasing to 1·80 billion (1·63-2·03) in 2023, alongside a concurrent 4·1% (1·9-6·3) reduction in age-standardised rates. Based on DALY counts, the leading level 3 NCDs in 2023 were ischaemic heart disease (193 million [176-209] DALYs), stroke (157 million [141-172]), and diabetes (90·2 million [75·2-107]), with the largest increases in age-standardised rates since 2010 occurring for anxiety disorders (62·8% [34·0-107·5]), depressive disorders (26·3% [11·6-42·9]), and diabetes (14·9% [7·5-25·6]). Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837-917) in 2010 to 681 million (642-736) in 2023, and a 25·8% (22·6-28·7) reduction in age-standardised DALY rates. During the COVID-19 pandemic, DALYs due to CMNN diseases rose but returned to pre-pandemic levels by 2023. From 2010 to 2023, decreases in age-standardised rates for CMNN diseases were led by rate decreases of 49·1% (32·7-61·0) for diarrhoeal diseases, 42·9% (38·0-48·0) for HIV/AIDS, and 42·2% (23·6-56·6) for tuberculosis. Neonatal disorders and lower respiratory infections remained the leading level 3 CMNN causes globally in 2023, although both showed notable rate decreases from 2010, declining by 16·5% (10·6-22·0) and 24·8% (7·4-36·7), respectively. Injury-related age-standardised DALY rates decreased by 15·6% (10·7-19·8) over the same period. Differences in burden due to NCDs, CMNN diseases, and injuries persisted across age, sex, time, and location. Based on our risk analysis, nearly 50% (1·27 billion [1·18-1·38]) of the roughly 2·80 billion total global DALYs in 2023 were attributable to the 88 risk factors analysed in GBD. Globally, the five level 3 risk factors contributing the highest proportion of risk-attributable DALYs were high systolic blood pressure (SBP), particulate matter pollution, high fasting plasma glucose (FPG), smoking, and low birthweight and short gestation-with high SBP accounting for 8·4% (6·9-10·0) of total DALYs. Of the three overarching level 1 GBD risk factor categories-behavioural, metabolic, and environmental and occupational-risk-attributable DALYs rose between 2010 and 2023 only for metabolic risks, increasing by 30·7% (24·8-37·3); however, age-standardised DALY rates attributable to metabolic risks decreased by 6·7% (2·0-11·0) over the same period. For all but three of the 25 leading level 3 risk factors, age-standardised rates dropped between 2010 and 2023-eg, declining by 54·4% (38·7-65·3) for unsafe sanitation, 50·5% (33·3-63·1) for unsafe water source, and 45·2% (25·6-72·0) for no access to handwashing facility, and by 44·9% (37·3-53·5) for child growth failure. The three leading level 3 risk factors for which age-standardised attributable DALY rates rose were high BMI (10·5% [0·1 to 20·9]), drug use (8·4% [2·6 to 15·3]), and high FPG (6·2% [-2·7 to 15·6]; non-significant). INTERPRETATION: Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural risk factors, juxtaposed with sizeable increases in DALYs attributable to metabolic risk factors and NCDs in growing and ageing populations. This long-observed consequence of the global epidemiological transition was only temporarily interrupted by the COVID-19 pandemic. The substantially decreasing CMNN disease burden, despite the 2008 global financial crisis and pandemic-related disruptions, is one of the greatest collective public health successes known. However, these achievements are at risk of being reversed due to major cuts to development assistance for health globally, the effects of which will hit low-income countries with high burden the hardest. Without sustained investment in evidence-based interventions and policies, progress could stall or reverse, leading to widespread human costs and geopolitical instability. Moreover, the rising NCD burden necessitates intensified efforts to mitigate exposure to leading risk factors-eg, air pollution, smoking, and metabolic risks, such as high SBP, BMI, and FPG-including policies that promote food security, healthier diets, physical activity, and equitable and expanded access to potential treatments, such as GLP-1 receptor agonists. Decisive, coordinated action is needed to address long-standing yet growing health challenges, including depressive and anxiety disorders. Yet this can be only part of the solution. Our response to the NCD syndemic-the complex interaction of multiple health risks, social determinants, and systemic challenges-will define the future landscape of global health. To ensure human wellbeing, economic stability, and social equity, global action to sustain and advance health gains must prioritise reducing disparities by addressing socioeconomic and demographic determinants, ensuring equitable health-care access, tackling malnutrition, strengthening health systems, and improving vaccination coverage. We live in times of great opportunity. FUNDING: Gates Foundation and Bloomberg Philanthropies.

The poultry industry contributes significantly to bridging the nutritional gap in many countries because of its meat and eggs products rich in protein and valuable nutrients at a cost less than other animal meat sources. The natural antibiotics alternatives including probiotics, prebiotics, symbiotics, organic acids, essential oils, enzymes, immunostimulants, and phytogenic (phytobiotic) including herbs, botanicals, essential oils, and oleoresins are the most common feed additives that acquire popularity in poultry industry following the ban of antibiotic growth promoters (AGPs). They are commonly used worldwide because of their unique properties and positive impact on poultry production. They can be easily mixed with other feed ingredients, have no tissue residues, improve feed intake, feed gain, feed conversion rate, improve bird immunity, improve digestion, increase nutrients availability as well as absorbability, have antimicrobial effects, do not affect carcass characters, decrease the usage of antibiotics, acts as antioxidants, anti-inflammatory, compete for stress factors and provide healthy organic products for human consumption. Therefore, the current review focuses on a comprehensive description of different natural antibiotic growth promoters' alternatives, the mode of their action, and their impacts on poultry production.